Group B <i>Streptococcus</i> Colonization Detection by Selective Broth Culture and DNA Probe

*Group B Streptococcus* Colonization Detection by Selective Broth Culture and DNA Probe**

Number
	188128
CPT
	87081; 87149
Related Information
	Default Test Order for Ambiguous Orders
Synonyms
	Beta-Hemolytic Strep Culture, Vaginal and/or Rectal ; Beta-Hemolytic Streptococcus Culture, Group B Only, Any Source ; Culture, Genital, Group B Beta-Hemolytic Streptococcus ; Genital Beta-Hemolytic Culture, Group B ; Genital Culture Group B Beta-Hemolytic Streptococcus ; Group B Beta-Hemolytic Strep Culture, Vaginal or Rectal
Test Includes
	Selective broth culture and DNA probe. If susceptibilities are performed, an additional charge will be added (CPT code 87184). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. Requests with only a written order and no test number indicated will be processed according to Default Test Order for Ambiguous Orders .
Specimen
	Swab of vaginal and rectal specimen
Volume
	One or two swabs
Container
	Bacterial swab transport
Collection
	Do not lubricate speculum. Move swab from side to side, or rotate the swab at the collection site, allowing several seconds for absorption of organisms by the swab. Return the swab to the transport tube and label.
Storage Instructions
	Maintain specimen at room temperature.
Causes for Rejection
	Inappropriate specimen transport conditions; improper labeling; specimen received after prolonged delay (usually more than 72 hours); specimen in expired transport
Use
	Isolate and identify group B beta streptococci
Methodology
	Selective broth culture and DNA probe
Additional Information
	Group B Streptococcus is currently one of the most significant human pathogens in the neonatal period. The most common mode of acquisition by the neonate is exposure to the maternal genital flora in utero through ruptured membranes or by contamination during passage through the birth canal. Infection is manifested in two major forms, early-onset septicemic infection manifest in the first few days of life and late-onset meningitis that occurs during the first few months of life. Susceptibility testing is not routinely performed as this organism is universally susceptible to penicillin, and surveillance for resistance is not recommended. If susceptibilities are performed, an additional charge will be added (CPT code 87184). The Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend reflex susceptibility testing to clindamycin and erythromycin for group B Streptococcus only for those patients at high risk for anaphylactic shock due to penicillin allergy. For those patients without likely evidence of severe anaphylaxis, the CDC and ACOG recommend the use of cefazolin as the agent of choice for intrapartum chemoprophylaxis without the need for susceptibility testing. For those patients with group B Streptococcus that is resistant to both erythromycin and clindamycin, the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG) recommend treatment with vancomycin without the need for additional susceptibility testing.
References
	Bourbeau PP, Heiter BJ, and Figdore M, “Use of Gen-Probe® AccuProbe Group B Streptococcus Test to Detect Group B Streptococci in Broth Cultures of Vaginal-Anorectal Specimens From Pregnant Women: Comparison With Traditional Culture Method,” J Clin Microbiol, 1997, 35(1):144-7. Brady K, Duff P, Schilhab JC, et al, “Reliability of a Rapid Latex Fixation Test for Detecting Group B Streptococci in the Genital Tract of Parturients at Term,” Obstet Gynecol, 1989, 73(4):678-81. Centers for Disease Control and Prevention, “Prevention of Group B Streptococcal Diseases: A Public Health Perspective Notice,” Federal Register, 1994, 59(240):64764-73. Centers for Disease Control and Prevention, “Prevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective,” MMWR, 1996, 45(RR 7):1-24. Centers for Disease Control and Prevention, “Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines From CDC,” MMWR, 2002, 51(RR-11):1-22. Stiller RJ, Blair E, Clark P, et al, “Rapid Detection of Vaginal Colonization With Group B Streptococci by Means of Latex Agglutination,” Am J Obstet Gynecol, 1989, 160(3):566-8.